创伤后 12 个月严重创伤事故幸存者创伤后应激障碍、生活质量、社会支持与情感及分离状态的关系。

Relationship between posttraumatic stress disorder, quality of life, social support, and affective and dissociative status in severely injured accident victims 12 months after trauma.

机构信息

Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, A - 8036 Graz, Austria.

出版信息

Psychosomatics. 2010 May-Jun;51(3):237-47. doi: 10.1176/appi.psy.51.3.237.

Abstract

BACKGROUND

Many survivors of severe injuries develop significant psychiatric morbidity, especially trauma-related psychiatric disorders, anxiety, and depressive disorders.

OBJECTIVE

The authors examined accident-related partial and full posttraumatic stress disorder (PTSD), including dimensions such as dissociation and depression and health-related quality of life in 52 severely injured accident victims 12 months after trauma.

METHOD

Respondents were given a questionnaire battery, as well as structured clinical interviews, a brief author-compiled questionnaire, self-report questionnaires, and psychometric observer-rated scales.

RESULTS

One-fourth of respondents met all criteria for PTSD, and another 21.2% had subsyndromal PTSD. Patients with PTSD showed higher severity of dissociative and depressive symptoms and major impairments in some dimensions of quality of life. Injury severity and symptoms of cognitive dysfunction did not influence accident-related PTSD or depressive or dissociative symptoms.

CONCLUSION

Severely injured accident victims seem to face a major risk of PTSD and impairments in health-related quality of life. For patients with polytrauma, there is a need for a biopsychosocial conceptual framework at the interface of psychiatry and trauma surgery in general hospitals.

摘要

背景

许多严重创伤的幸存者会出现明显的精神疾病发病率,尤其是创伤相关的精神障碍、焦虑和抑郁障碍。

目的

作者在创伤后 12 个月检查了 52 名严重创伤事故受害者的与事故相关的部分和完全创伤后应激障碍(PTSD),包括分离和抑郁等维度,以及与健康相关的生活质量。

方法

受访者接受了问卷调查、结构化临床访谈、简短的作者编制问卷、自我报告问卷和心理测量观察量表评估。

结果

四分之一的受访者符合 PTSD 的所有标准,另有 21.2%的人存在亚综合征 PTSD。患有 PTSD 的患者表现出更严重的分离和抑郁症状,以及一些生活质量维度的严重损害。损伤严重程度和认知功能障碍症状并未影响与事故相关的 PTSD、抑郁或分离症状。

结论

严重创伤事故的受害者似乎面临着 PTSD 和与健康相关的生活质量受损的重大风险。对于多发伤患者,综合医院的精神病学和创伤外科之间需要一种生物心理社会概念框架。

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